Cameras in aged care rooms: privacy vs peace of mind

The Minister for Aged Care has indicated the installation of cameras in all aged care homes is on the table following the airing of the second part of a Four Corners investigation into the sector, but industry reaction has been tentative.

Aged care and older persons’ bodies have stopped short of publicly backing the call – and of rebutting it.

The Four Corners episode that aired on Monday night showed hidden camera footage of residents being struck by aged care staff, prompting viewers to question whether cameras should be installed in all rooms.

Would you consider using a hidden camera to ensure your loved one is being adequately cared for? #4Corners#agedcareRC

When asked about that by ABC radio on Tuesday, Minister Ken Wyatt indicated that he was at least open to the idea.

“I can appreciate the families who are very strongly supportive now of cameras within those rooms,” he said. “None of this would have been known without that footage as to how those individuals were treated.”

COTA Australia chief executive Ian Yates backed Wyatt’s comments about the action taken by family members to bring issues to light.

Yates said: “We understand that – and the authorities have been very clear that – they are not overly concerned about the breach of privacy and recording legislation because there were genuine reasons for doing that.

“On the other hand, I think that we don’t really want to propagate an ideal of aged care that involves high levels of CCTV surveillance.”

Instead, the ideal propagated should be on improving quality in ways that mean such intervention is unnecessary, he said.

Matthew Richter, chief executive of the Aged Care Guild, an association of eight of the largest private residential aged care providers, said while the group recognises that cameras can give peace of mind to residents and families – and potentially help prevent rogue behaviour and criminal incidents – it’s important to remember that residential aged care facilities are not hospitals, but rather a person’s home.

“Residents deserve the same level of privacy and dignity that we are all afforded in our homes,” Richter said. “Decisions concerning the installation of cameras should be made between an individual resident, their family and their care provider.”

Karl Rozenbergs, a partner at Hall & Wilcox lawyers, said should a provider decide that the safety of the resident trumps privacy concerns, there are still a number of workplace surveillance laws across the country to contend with – and they differ between states and territories.

“What that means is that people running the facility can’t just put in the surveillance. The only way to get around that legislation is if the parties consent.

“Then you have issues around the capacity of the person to consent, especially in circumstances where the resident has the onset of dementia.”

Yates said there are many residents who might want to have their own privacy and freedom to do whatever they want to behind their closed doors. He added that family members who consent to CCTV surveillance on behalf of their loved one in aged care might not make the decision their relative would have.

Indeed, this potential discrepancy was highlighted by a survey conducted in 2014 by British aged care provider HC-One, which Rozenbergs pointed to in a piece he wrote for Aged Care Insite.

In it, he explained that of those surveyed, only 47 per cent of residents supported the idea of CCTV cameras in aged-care facilities, compared with 87 per cent of relatives. “This means that in circumstances where a resident can no longer consent to the use of CCTV cameras, it is highly likely that a relative’s decision would be against the resident’s wishes,” Rozenbergs wrote.

Fellow Hall & Wilcox lawyer Melinda Bell said making decisions surrounding surveillance is a way for older people moving into aged care facilities to maintain independence and feel in control.

Bell added privacy is considered a fundamental human right and contemplated the gap in surveillance legislation in that it doesn’t really address the use of CCTV in a residential aged care situation – a place regarded as both a home and a workplace.

“Someone could go into an aged care facility and, as part of their documentation when they go in, indicate that they don’t consent to the use of CCTV. Later, the power of attorney might be in place and the family may change the wishes of that person.

Yates said a further issue with this mismatch is that the ageist attitudes permeating society also apply within families. As an example, family members might not consider the sexual needs of older, frailer loved ones.

“We need to look to the rights of people to enjoy agency in their lives, and they can, even if they don’t have full legal capacity,” Yates said.

“There’s also the whole issue of the potential for this kind of proposed surveillance to itself end up in an unsavoury way in terms of who is what looking at whom and what gets kept.”

Bell and Rozenbergs agreed that this is a concern. They said even if there is consent to CCTV use, there are issues surrounding storage and handling, including questions of who can access the footage, how long it can be stored for, who can view it and how it is used.

Yates said rather than infantilising older adults and surveilling them at all points in time, the discussion should focus on exploring how CCTV might be used if there is due cause.

Rozenbergs agreed, saying: “If you really want to tackle elder abuse – and it’s an increasing issue – then maybe you look at reforms to surveillance laws to allow aged care providers to implement CCTV cameras in certain circumstances. The circumstance might be when they suspect elder abuse.”

He added there is also scope for the Royal Commission to explore circumstances where consent is not required and providers move ahead with the installation cameras, and added: “Ultimately it may be that the only real solution to tackling elder abuse is to have some form of CCTV in the room.”

One comment

CCTV is not the answer to elder abuse. What is required to stop elder abuse in nursing facilities (I cannot call them homes) is to increase staffing to levels commensurate with quality of care.
At present, a shortage of Registered Nurses and shortened numbers of personal care attendants cause overwork and high levels of stress which in turn cause abuse and neglect.